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Sedgwick is seeking a US Telecommuter RN Telephonic Case Manager for a full-time remote role. You will support injured workers, employers and providers, coordinating medical services and advocating for timely recovery and return-to-work.

Jobgether represents a partner company seeking a Clinical Denials Management Specialist based in the United States. The role is fully remote and focuses on reviewing, appealing, and preventing denied hospital claims across a healthcare system,...

CVS Health is hiring a full-time RN for healthcare services and utilization management. The role emphasizes assessing and coordinating care, applying clinical criteria, and communicating with providers to optimize member outcomes. The...

Health Care Service Corporation seeks a Quality of Care (QOC) Nurse to review and investigate potential quality of care issues in a timely manner. This role supports QA activities in line with CMS and NCQA requirements, under the supervision of...

LifeBridge Health's Sinai Hospital Utilization Review team is seeking a remote, full-time RN to conduct initial, concurrent and retrospective chart reviews, applying UR criteria to ensure hospital stays are appropriate and fully covered by...

Utilization Review Specialist (RN) – Work From Home (Florida-Based Candidates Only)Concierge Home Care | Work From Home Opportunity – Must Reside in Florida At Concierge Home Care, we are growing and looking for an experienced...

LPN - Licensed Practical Nurse - Outpatient Vein Center - Clifton Park, NY - FT - Days Join St. Peter's Health Partners (SPHP) as a compassionate LPN in our Outpatient Vein Center office, where you'll deliver skilled nursing care. Your...

A leading healthcare provider is seeking an Associate RN for a remote role dedicated to acting as a care guide and advocate for patients. The candidate must hold a valid RN license in a compact state or California. Responsibilities include...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse - Prior Authorization for a 12-month assignment. The role is remote (PST/CST) with scheduling across multiple shifts, supporting national guidelines and contractual requirements.

Essentia Health in Duluth, MN is hiring for a Health Services professional to conduct Managed Care Programs in coordination with third party administrators. You will help implement referral, prior authorization, and precertification processes...

Job Description WHAT YOU'LL DO As an admissions nurse at VITAS Healthcare, you will be the first face of hospice for patients and families. Your meeting will likely be the first time they...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

Beth Israel Lahey Health is seeking a Registered Nurse for remote triage in Primary Care from Exeter, NH. The role focuses on telephone-based assessment, guiding patients to the right care setting, and coordinating follow-up with care teams.

BSFW-FORT WORTH IS LOOKING FOR A FULL-TIME PCT TECH IN OUR PSU DEPARTMENT, DAY SHIFT. WHO WE ARE At USPI, we create relationships that create better care. We partner with physicians and health care systems to provide first class...

Centene Corporation in the United States is seeking a Nursing professional to analyze prior authorization requests and determine medical necessity and level of care in line with standards and coverage. You will collaborate with medical teams to...

Job Description Description: Work Schedule: Day/evening, you will work six 10-hour shifts per pay period including weekend rotation. Holiday rotation required. Hours are based off...

Humana Inc. seeks a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care, including SNF, home health and DME. You...

A-Line Staffing Solutions is seeking a Clinical Review Nurse for a concurrent review role in a remote-capable setting. The RN will assess member eligibility through chart review and coordinate with providers to gather necessary information.

Registered Nurse (RN Juvenile Corrections: Downey, CA Job Type : Assignment City : Downey State : CA Job Description: Registered Nurse...

A healthcare company seeks a Remote Utility Management Nurse to optimize insurance coding practices and enhance revenue management. This part-time role offers flexible hours and compensation ranging from $45 to $75 per hour, depending on...

Optum Home & Community Care Registered Nurse Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that...

Working remotely in a full-time capacity, the Registered Nurse Virtual Care (NC) will monitor patient conditions, adjust care plans, and collaborate with care teams while engaging in professional governance and quality initiatives during night...

Kaiser Permanente in Downey, CA seeks an experienced Registered Nurse to coordinate discharge planning and post-acute care. Works with MDs to assess admissions and plan appropriate levels of care, ensuring safe transitions and cost-effective care.

Peraton is a next-generation national security company that drives missions of consequence worldwide. As Nurse Reviewer Team Lead you will mentor the medical review team, oversee workloads, and ensure timely development and resolution of medical...

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...